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Epiglottitis is an inflammation of the epiglottis that can result from an infection or other cause, such as physical trauma. A severely swollen epiglottis can block the airway, causing severe breathing difficulties. It can be fatal.

Another name for epiglottitis is supraglottitis, but supraglottitis also involves inflammation of the cartilage that is near the voice box.

The epiglottis is the cartilage flap at the base of the tongue. When a person swallows, the epiglottis stops solid food and liquids from going down through the voice box and windpipe to the lungs.

Why is epiglottitis serious?

A very sore throat is one possible symptom of epiglottitis, but it can also lead to breathing difficulties, which can be life-threatening.

The location of the epiglottis means that if it swells, it can block the airway. This can cause serious breathing difficulties. For this reason, epiglottitis is a medical emergency.

Sometimes, severe epiglottitis can cause the windpipe to close completely so that the person cannot breathe.

If this happens, the person will need immediate medical attention. The symptoms can worsen quickly, sometimes becoming fatal within hours.

Epiglottitis used to be common among young children, before the introduction of the Hemophilus influenzae type B vaccine (Hib) vaccine. Now, there are far fewer cases of epiglottitis, but they do occur.

Children who have not yet completed the recommended series of vaccinations for Hib are at risk for Hib infections, including epiglottitis. Infection caused by other bacteria or viruses can also lead to epiglottitis.

According to the Centers for Disease Control and Prevention (CDC), an average of 2,562 Hib infections occurred every year in the United States from 2003 to 2010, from all age groups.

Treatment

A person with a diagnosis of epiglottitis must go to the hospital immediately.

The medical team will secure the person's airway, starting with an oxygen mask to make sure they are getting enough oxygen.

If an oxygen mask is not sufficient, the doctor may need to insert a tube to take oxygen to the lungs. The doctor will insert the tube into the person's mouth, or sometimes the nose. The tube goes past the epiglottis and into the windpipe.

In severe cases, the person may need a tracheostomy or cricothyroidotomy. This is a procedure in which a surgeon places a breathing tube directly through the person's neck and into their windpipe, bypassing the epiglottis.

The doctor will give an injection of broad-spectrum antibiotics. Even if the condition is due to heat or chemical exposure, a person is still at risk of developing a bacterial infection.

If the tests show exactly what kind of infection the person has, the doctor will prescribe more targeted medications.

Complications

The most dangerous complication is the inability to breathe, which is life-threatening.

If there is an infection, it might cause other conditions, such as otitis media, also called middle ear infection, pneumonia, meningitis, or pericarditis, which is inflammation of the lining around the heart.

Prevention

Since children started having the Hib vaccine as a routine measure, the number of cases of epiglottitis has fallen dramatically.

Hib is a significant risk factor for epiglottitis. According to the Immunization Action Coalition, 50–65 percent of infections lead to meningitis, and 17 percent lead to epiglottitis.

According to the CDC, the number of cases of invasive Hib disease in the U.S. started to fall dramatically in the late 1980s, around the time Hib vaccines became routine for children.

Since a vaccination has been readily available, the incidence of epiglottitis has fallen by more than 99 percent.

This improvement shows the effectiveness of the Hib vaccination.

Takeaway

Epiglottitis is a severe condition that occurs when inflammation causes the epiglottis to swell up. One of the leading causes is an infection, but other conditions can cause it, too.

There is a risk that the person may become unable to breathe. If this happens, it can be fatal. For this reason, a person who has or suspects they may have epiglottitis needs immediate medical attention.

The best way to prevent epiglottitis due to Hib is by vaccinating a child against Hib. The vaccination will protect the child and others in the community.

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